Clinical expertise, care coordination and member support working together to identify needs earlier and improve outcomes.
Unlike fragmented models where clinical programs operate separately, Imagine360 connects four integrated programs to create a more coordinated care experience.
Uses evidence-based clinical review to help ensure the right care at the right time and setting, while identifying members who may benefit from additional support.
Provides clinical guidance to help members make informed care decisions and navigate recovery.
Provides personalized support and care coordination for complex medical needs.
Provides ongoing support for chronic conditions and maternity needs.
At Imagine360, insights from across the care journey provide a more complete understanding of member needs, helping our teams coordinate the right support. Earlier intervention can help prevent issues from escalating into avoidable emergency visits, hospitalizations, and other high-cost events.
Gain insight beyond a single claim, authorization or interaction.
Help address challenges with access, medications, scheduling and more.
Connect members with specialized clinical support when needed.
These results highlight the impact of a more connected approach to Medical Management.
Medical Management is the part of a health plan that brings together clinical expertise, care coordination and member support to help members navigate their healthcare needs. At Imagine360, our integrated programs work together to identify needs earlier, coordinate support and improve outcomes throughout the healthcare journey.
Care coordination brings together information, resources, and clinical expertise to help members navigate their healthcare needs. At Imagine360, insights from across the care journey help our teams address barriers to care, coordinate support, and bring in specialized expertise when needed.
Imagine360 Medical Management includes Utilization Management, Nurse Triage, Case Management and Disease Management, with optional solutions for wellness and health coaching, virtual care, and ongoing chronic condition support to meet additional workforce needs.
Clinical reviews, utilization activity, care transitions, risk insights, and member interactions can all help identify opportunities for additional support. Because our programs work together, insight from one interaction can help connect members with additional support when needed.
At Imagine360, our integrated Medical Management approach helps employers control healthcare costs by supporting appropriate care, identifying needs earlier, and coordinating support to help reduce avoidable utilization and complications.
Self-funded employers pay for healthcare claims directly, making proactive clinical support especially important. Medical Management helps identify needs earlier, coordinate care and reduce avoidable utilization, which can improve outcomes for members while helping employers better manage healthcare costs.
Yes. Imagine360’s Utilization Management, Case Management and Disease Management programs have earned URAC accreditation.
